[Physical activity and chronic disease II. Type 2 diabetes, obesity and cancer].
Explore the source record for details and available documents.
Chronic Disease↗
Biomedical subjects
Flemming Dela
Publications and source records attributed to Flemming Dela.
[Physical activity and chronic disease III. Musculoskeletal diseases and lung diseases].
Explore the source record for details and available documents.
Asthma↗
The CSF and arterial to internal jugular venous hormonal differences during exercise in humans.
Strenuous exercise increases the cerebral uptake of carbohydrate out of proportion to that of oxygen, but it is unknown whether such enhanced carbohydrate uptake is influenced by the marked endocrine response to exercise. During exhaustive exercise this study evaluated the a-v differences across the brain (a-v diff) of hormones that could influence its carbohydrate uptake (n= 9). In addition, neuroendocrine activity and a potential uptake of hormones via the cerebrospinal fluid (CSF) were assessed by lumbar puncture postexercise and at rest (n= 6). Exercise increased the arterial concentration of noradrenaline and adrenaline, but there was no cerebral uptake. However, following exercise CSF noradrenaline was 1.4 (0.73-5.5) nmol l(-1), and higher than at rest, 0.3 (0.19-1.84) nmol l(-1) (P < 0.05), whereas adrenaline could not be detected. Exercise increased both the arterial concentration of NH(4)(+) and its a-v diff, which increased from 1 (-12 to 5) to 17 (5-41) micromol l(-1) (P < 0.05), while the CSF NH(4)(+) was reduced to 7 (0-10) versus 11 (7-16) micromol l(-1) (P < 0.05). There was no release from, or accumulation in the brain of interleukin (IL)-6, tumour necrosis factor (TNF-alpha), heatshock protein (HSP72), insulin, or insulin-like growth factor (IGF)-I. The findings indicate that for maximal exercise, the concentration of noradrenaline is increased within the brain, whereas blood borne hormones and cytokines are seemingly unimportant. The results support the notion that the exercise-induced changes in brain metabolism are controlled by factors intrinsic to the brain.
Adult↗
Effects of strength training on muscle lactate release and MCT1 and MCT4 content in healthy and type 2 diabetic humans.
UNLABELLED: Lactate is released from skeletal muscle in proportion to glucose uptake rates, and it leaves the cells via simple diffusion and two monocarboxylate transporter proteins, MCT1 and MCT4. In response to endurance training MCT1 - and possibly MCT4 - content in muscle increases. The MCTs have not previously been measured in patients with type 2 diabetes (Type 2), and the response to strength training is unknown. Ten Type 2 and seven healthy men (Control) strength-trained one leg (T) 3 times a week for 6 weeks while the other leg remained untrained (UT). Each session lasted no more than 30 min. After strength training, muscle biopsies were obtained and an isoglycaemic, hyperinsulinaemic clamp, combined with arterial and femoral venous catheterization of both legs, was carried out. During hyperinsulinaemia lactate release was always increased in T versus UT legs. MCT1 was lower (P<0.05) and MCT4 similar in Type 2 versus Control. With training, MCT1 content always increased, while MCT4 only increased in Control. CONCLUSIONS: MCT1 content in skeletal muscle in Type 2 is lower compared with healthy men. Strength training increases MCT1 content in healthy men and in Type 2, thus normalizing the content in Type 2.
Blood Glucose↗
Effect of hyperglycemia and hyperinsulinemia on the response of IL-6, TNF-alpha, and FFAs to low-dose endotoxemia in humans.
Insulin therapy to maintain euglycemia increases survival in critically ill patients. To explore possible mechanisms of action, we investigated the effect of endotoxin on circulating cytokines, free fatty acids (FFA), and leukocytes during manipulated plasma glucose and insulin concentrations. Ten volunteers underwent three trials each, receiving an intravenous bolus of endotoxin (0.2 ng/kg) during normoglycemia (trial A, control), during a hyperglycemic clamp at 15 mM (trial B), and during a hyperinsulinemic euglycemic clamp (trial C). Endotoxin induced an increase in neutrophil count, a decrease in lymphocyte count, and an increase in serum levels of TNF-alpha, IL-6, and FFA. There was no difference in the TNF response between the three trials; the IL-6 levels were increased during the late phase of trials B and C compared with trial A. The endotoxin-induced elevation in FFA in trial A was suppressed during trials B and C. Clamping (trials B and C) caused a reduction in lymphocyte count that persisted after endotoxin injection. We conclude that low-dose endotoxemia triggers a subclinical inflammatory response and an elevation in FFA. The finding that high insulin serum concentrations induce a more prolonged increase in the anti-inflammatory cytokine IL-6 and suppress the levels of FFA suggests that insulin treatment of patients with sepsis may exert beneficial effects by inducing anti-inflammation and protection against FFA toxicity, and thereby inhibit FFA-induced insulin resistance.
Adult↗
Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes.
Strength training represents an alternative to endurance training for patients with type 2 diabetes. Little is known about the effect on insulin action and key proteins in skeletal muscle, and the necessary volume of strength training is unknown. A total of 10 type 2 diabetic subjects and 7 healthy men (control subjects) strength-trained one leg three times per week for 6 weeks while the other leg remained untrained. Each session lasted no more than 30 min. After strength training, muscle biopsies were obtained, and an isoglycemic-hyperinsulinemic clamp combined with arterio-femoral venous catheterization of both legs was carried out. In general, qualitatively similar responses were obtained in both groups. During the clamp, leg blood flow was higher (P < 0.05) in trained versus untrained legs, but despite this, arterio-venous extraction glucose did not decrease in trained legs. Thus, leg glucose clearance was increased in trained legs (P < 0.05) and more than explained by increases in muscle mass. Strength training increased protein content of GLUT4, insulin receptor, protein kinase B-alpha/beta, glycogen synthase (GS), and GS total activity. In conclusion, we found that strength training for 30 min three times per week increases insulin action in skeletal muscle in both groups. The adaptation is attributable to local contraction-mediated mechanisms involving key proteins in the insulin signaling cascade.
Biological Transport↗
Effect of resistance training on Na,K pump and Na+/H+ exchange protein densities in muscle from control and patients with type 2 diabetes.
Ten patients with type 2 diabetes and seven controls were strength-trained with one leg for 30 min three times per week for 6 weeks. The training-induced changes in the protein densities of the Na,K-pump subunits and the Na+/H+ exchanger protein NHE1 were quantified with Western blotting of needle biopsy material obtained from trained and untrained legs of both groups. Training increased the bench press and knee-extensor force by 77+/-15 and 28+/-1%, respectively, in the control subjects, and by 75+/-7 and 42+/-8%, respectively, in the diabetics. In the control subjects the Na,K-pump isoform alpha1 was increased by 37% (P<0.05) in trained compared to untrained leg, and in the diabetics the alpha1 content was 45% higher (P=0.052) in trained compared to untrained leg. For the alpha2 isoform the corresponding values were 21% and 41% (P<0.05), respectively. The content of the beta1 subunit in the control subjects was 33% higher (P<0.05) in trained compared to untrained leg, and 47% higher (P=0.06) in trained compared to untrained leg in the diabetics. Thus, a limited amount of strength-training is able to increase the Na,K-pump subunit and isoform content both in controls and in patients with type 2 diabetes.
Analysis of Variance↗
Cardiovascular control during exercise: insights from spinal cord-injured humans.
BACKGROUND: We studied the role of the central nervous system, neural feedback from contracting skeletal muscles, and sympathetic activity to the heart in the control of heart rate and blood pressure during 2 levels of dynamic exercise. METHODS AND RESULTS: Spinal cord-injured individuals (SCI) with (paraplegia, n=4) or without (tetraplegia, n=6) sympathetic innervation to the heart performed electrically induced exercise. Responses were compared with those established by able-bodied individuals (control, n=6) performing voluntary exercise at a similar pulmonary oxygen uptake. In all subjects, cardiac output and leg blood flow increased, but in SCI they reached a maximal value. The increase in cardiac output was mainly elicited by an increase in stroke volume in individuals with tetraplegia, whereas in individuals with paraplegia it was by heart rate. The increase in SCI was slow compared with that in controls. During exercise, blood pressure was stable in controls, whereas it decreased over time in SCI and especially in individuals with tetraplegia. CONCLUSIONS: The autonomic nervous system provides for acceleration of the heart at the onset of exercise, but a slow increase in heart rate is established even without central command, neural feedback from working muscles, or autonomic influence on the heart. Yet an intact autonomic nervous system is a prerequisite for a large rise in cardiac output and in turn leg blood flow during exercise. Thus, when the sympathetic nervous system is injured at a level where it influences the heart, vasodilatation in working muscles challenges blood pressure.
Blood Pressure↗
Proteome analysis reveals phosphorylation of ATP synthase beta -subunit in human skeletal muscle and proteins with potential roles in type 2 diabetes.
Insulin resistance in skeletal muscle is a hallmark feature of type 2 diabetes. An increasing number of enzymes and metabolic pathways have been implicated in the development of insulin resistance. However, the primary cellular cause of insulin resistance remains uncertain. Proteome analysis can quantitate a large number of proteins and their post-translational modifications simultaneously and is a powerful tool to study polygenic diseases like type 2 diabetes. Using this approach on human skeletal muscle biopsies, we have identified eight potential protein markers for type 2 diabetes in the fasting state. The observed changes in protein expression indicate increased cellular stress, e.g. up-regulation of two heat shock proteins, and perturbations in ATP (re)synthesis and mitochondrial metabolism, e.g. down-regulation of ATP synthase beta-subunit and creatine kinase B, in skeletal muscle of patients with type 2 diabetes. Phosphorylation appears to play a key, potentially coordinating role for most of the proteins identified in this study. In particular, we demonstrated that the catalytic beta-subunit of ATP synthase is phosphorylated in vivo and that the levels of a down-regulated ATP synthase beta-subunit phosphoisoform in diabetic muscle correlated inversely with fasting plasma glucose levels. These data suggest a role for phosphorylation of ATP synthase beta-subunit in the regulation of ATP synthesis and that alterations in the regulation of ATP synthesis and cellular stress proteins may contribute to the pathogenesis of type 2 diabetes.
Adenosine Triphosphate↗
Circulating levels of TNF-alpha and IL-6-relation to truncal fat mass and muscle mass in healthy elderly individuals and in patients with type-2 diabetes.
The purpose of the current study was to test the hypothesis that an altered fat distribution in elderly healthy subjects and in patients with type-2 diabetes contributes to high circulating levels of interleukin (IL)-6 and tumor necrotic factor (TNF)-alpha, which secondly is related to lower muscle mass. Twenty young controls, (20-35 yr), 20 healthy elderly subjects (65-80 yr) and 16 elderly patients with type 2 diabetes (65-80 yr) were included in a cross sectional study. Plasma levels of TNF-alpha and IL-6 were measured after an overnight fast. Dual-energy X-ray absorptiometry and total body potassium counting measured truncal fat, appendicular skeletal muscle mass (ASM) and body cell mass (BCM), respectively. TNF-alpha, IL-6 and the relative truncal fat mass were higher in elderly compared with young controls. ASM was lower in diabetic men than in young controls and BCM was lower in elderly men compared with young men. TNF-alpha and IL-6 were correlated with the absolute as well as the relative truncal fat mass in univariate regression analyses. Similar results were found in multivariate linear regression analyses after adjusting for the effect of age and gender. TNF-alpha was related to lower ASM and BCM in elderly men both in a univariate regression analysis and a multivariate regression analysis. In conclusion, high plasma levels of TNF-alpha and IL-6 in elderly healthy people and in patients with type 2 diabetes are associated with increased truncal fat mass, suggesting that cytokines are partly derived from this adipose tissue bed. Furthermore, TNF-alpha was related to lower ASM and BCM, suggesting that TNF-alpha contributes to sarcopenia in ageing.
Adipose Tissue↗
Insulin secretion and cellular glucose metabolism after prolonged low-grade intralipid infusion in young men.
We examined the simultaneous effects of a 24-h low-grade Intralipid infusion on peripheral glucose disposal, intracellular glucose partitioning and insulin secretion rates in twenty young men, by 2-step hyperinsulinemic euglycemic clamp [low insulin clamp (LI), 10 mU/m(2) x min; high insulin clamp (HI), 40 mU/m(2) x min], 3-(3)H-glucose, indirect calorimetry, and iv glucose tolerance test. Free fatty acid concentrations were similar during basal steady state but 3.7- to 13-fold higher during clamps. P-glucagon increased and the insulin/glucagon ratio decreased at both LI and HI during Intralipid infusion. At LI, glucose oxidation decreased by 10%, whereas glucose disposal, glycolytic flux, glucose storage, and glucose production were not significantly altered. At HI, glucose disposal, and glucose oxidation decreased by 12% and 24%, respectively, during Intralipid infusion. Glycolytic flux, glucose storage, and glucose production were unchanged. Insulin secretion rates increased in response to Intralipid infusion, but disposition indices (DI = insulin action.insulin secretion) were unchanged. In conclusion, a 24-h low-grade Intralipid infusion caused insulin resistance in the oxidative (but not in the nonoxidative) glucose metabolism in young healthy men. Moreover, insulin hypersecretion perfectly countered the free-fatty acid-induced insulin resistance. Future studies are needed to determine the role of a prolonged moderate lipid load in subjects at increased risk of developing diabetes.
Adult↗
Effect of training on muscle triacylglycerol and structural lipids: a relation to insulin sensitivity?
We studied whether endurance training impacts insulin sensitivity by affecting the structural and storage lipids in humans. Eight male subjects participated (age 25 +/- 1 years, height 178 +/- 3 cm, weight 76 +/- 4 kg [mean +/- SE]). Single-leg training was performed for 30 min/day for 4 weeks at approximately 70% of single-leg maximal oxygen uptake. After 8, 14, and 30 days, a two-step hyperinsulinemic-euglycemic glucose clamp, combined with catheterization of an artery and both femoral veins, was performed. In addition, a muscle biopsy was obtained from vastus lateralis of both legs. Maximal oxygen uptake increased by 7% in the trained leg (T), and training workload increased (P < 0.05) from 79 +/- 12 to 160 +/- 15 W. At day 8, glucose uptake was higher (P < 0.01) in the trained (0.8 +/- 0.2, 6.0 +/- 0.8, 13.4 +/- 1.2 mg x min(-1) x kg(-1) leg wt) than the untrained leg (0.5 +/- 0.2, 3.7 +/- 0.6, 10.5 +/- 1.5 mg x min(-1) x kg(-1) leg wt) at basal and the two succeeding clamp steps, respectively. After day 8, training did not further increase leg glucose uptake. Individual muscle triacylglycerol fatty acid composition and total triacylglycerol content were not significantly affected by training and thus showed no relation to leg glucose uptake. Individual muscle phospholipid fatty acids were not affected by training, but the content of phospholipid polyunsaturated fatty acids was higher (P < 0.06) after 30 than 8 days in T. Furthermore, after 30 days of training, the sum of phospholipid long-chain polyunsaturates was correlated to leg glucose uptake (r = 0.574, P < 0.04). Endurance training did not influence muscle triacylglycerol content or total triacylglycerol fatty acid composition. In contrast, training induced a minor increase in the content of phospholipid fatty acid membrane polyunsaturates, which may indicate that membrane lipids may have a role in the training-induced increase in insulin sensitivity.
Adult↗
[Physical training in the treatment of metabolic syndrome].
Increased daily physical activity is effective in the prevention of type 2 diabetes and several of the components in the metabolic syndrome. However, dedicated efforts in exercise training will also be effective in the treatment of the metabolic syndrome. The effect on glycaemic control is of the same order of magnitude as can be achieved by oral antidiabetic drugs. In addition, exercise (endurance and/or strength training) will also improve insulin resistance and body composition. The results are more doubtful for the dyslipidaemia and hypertension, but if the training is combined with an appropriate diet, these abnormalities are also correctable.
Blood Glucose↗
Early differential defects of insulin secretion and action in 19-year-old caucasian men who had low birth weight.
Several studies have linked low birth weight (LBW) and type 2 diabetes. We investigated hepatic and peripheral insulin action including intracellular glucose metabolism in 40 19-year-old men (20 LBW, 20 matched control subjects), using the hyperinsulinemic-euglycemic clamp technique at two physiological insulin levels (10 and 40 mU/m(2) per min), indirect calorimetry, and [3-(3)H]glucose. Insulin secretion was examined during an oral and intravenous glucose tolerance test. Fasting p-glucose was higher in the LBW group (5.6 +/- 0.1 vs. 5.4 +/- 0.1; P < 0.05). Basal plasma glycerol concentrations were significantly lower in the LBW group. Insulin-stimulated glycolytic flux was significantly reduced, and suppression of endogenous glucose production was enhanced in the LBW group. Nevertheless, basal and insulin-stimulated rates of whole-body peripheral glucose disposal, glucose oxidation, lipid oxidation, exogenous glucose storage, and nonoxidative glucose metabolism were similar in the two groups. Insulin secretion was reduced by 30% in the LBW group, when expressed relative to insulin sensitivity (disposition index = insulin secretion x insulin action). We propose that reduced insulin-stimulated glycolysis precedes overt insulin resistance in LBW men. A lower insulin secretion may contribute to impaired glucose tolerance and ultimately lead to diabetes.
3-Hydroxybutyric Acid↗